Question 1

Which condition causes pseudohypocalcemia?

Accepted Answer

Pseudohypocalcemia occurs when a portion of the calcium in the blood is bound to proteins such as albumin. Hypoalbuminemia, or a decreased level of albumin in the blood, can lead to a decrease in bound calcium and thus mimic the symptoms of hypocalcemia. However, the actual level of ionized calcium (the biologically active form) in the blood remains normal.

Question 2

A client has hypertension and elevated serum calcium concentration. Which condition is likely to occur in the client?

Accepted Answer

Osteopenia is likely to occur in a client with hypertension and elevated serum calcium concentration because the high calcium levels in the blood can lead to decreased calcium in the bones, making them weaker and more prone to osteopenia.

Question 3

A client has +3 pitting edema on the feet and also has ascites. What is the most important clinical feature to be monitored given this condition?

Accepted Answer

Serum albumin level. Pitting edema and ascites both indicate fluid accumulation in the body, which is commonly seen in liver disease. Monitoring serum albumin level is important in liver disease as it reflects the liver's ability to synthesize proteins, including albumin, which helps maintain oncotic pressure and prevent fluid accumulation.

Question 4

A 55-year-old hypervolemic client has headache, muscle cramp, vomiting, and looks confused. Which condition has the client developed?

Accepted Answer

The symptoms described are consistent with hyponatremia, which is the condition of having low sodium levels in the blood. The symptoms of hyponatremia can include headaches, muscle cramps, nausea or vomiting, confusion, seizures, and coma. A hypervolemic client is one who has an excess of fluid in the blood, which can dilute the sodium levels and lead to hyponatremia.

Question 5

A client is running a high temperature and is found to have fluid volume deficit. Which signs and symptoms are likely to appear in the client because of fluid volume deficit?

Accepted Answer

Orthostatic hypotension and poor skin turgor are signs of fluid volume deficit. Crackles in lungs and dyspnea are associated with fluid overload, and dark urine with low specific gravity is not typical of fluid volume deficit.

Question 6

During evaluation of a client who has undergone a bariatric surgery, the nurse finds that the client has an abnormally rapid heartbeat and hypotension. Which condition has the client developed?

Accepted Answer

As a result of bariatric surgery, the client may experience dehydration due to reduced water intake and malabsorption. Rapid heartbeat and hypotension are both symptoms of dehydration. Hypervolemia (excess fluid in the body) and hypernatremia (excess sodium in the blood) are not likely in this situation.

Question 7

A client has increased serum phosphorus levels. Which condition related to hyperphosphatemia would the nurse expect to find in the client?

Accepted Answer

Hyperphosphatemia can lead to hypocalcemia by binding with calcium and forming calcium phosphate deposits, reducing the amount of free calcium in the bloodstream.

Question 8

What is the best intervention to correct hypervolemic hyponatremia in a client diagnosed with a serum sodium level of 120 mEq/L?

Accepted Answer

Hypervolemic hyponatremia occurs when there is an excess of water in the body relative to the amount of sodium, and the primary treatment is to remove the excess water. Tolvaptan is a selective vasopressin V2 receptor antagonist that can increase urine output and decrease water retention, thereby correcting hyponatremia. Sevelamer is a medication used to lower phosphate levels and has no effect on sodium or water balance. Alendronate is a bisphosphonate used to treat osteoporosis and has no effect on sodium or water balance. Therefore, the best intervention for this client would be administration of tolvaptan. It is important to note that the correction of hyponatremia should be done slowly and carefully to avoid osmotic demyelination syndrome, a potentially life-threatening complication.

Question 9

Which substance is transported to the cells by facilitated transport?

Accepted Answer

facilitated transport is a passive transport process that uses carrier proteins to move molecules such as glucose across the cell membrane, without the need for energy expenditure by the cell. Therefore, glucose is the substance that is transported to the cells by facilitated transport. Sodium and potassium are mainly transported by active transport, while albumin is a protein that is too large to be transported by facilitated transport.

Question 10

Which substance can reduce the body's response to cardiac drugs?

Accepted Answer

Calcium can interfere with the action of certain cardiac drugs, particularly those that affect heart rhythm and contractility, by competing with the ions these drugs target or by affecting the overall electrolyte balance that is crucial for proper cardiac function.

Question 11

Which condition is called hypocalcemia?

Accepted Answer

Hypocalcemia is defined as a serum calcium level less than 8.5 mg/dL. Option B and C state incorrect values, and option D does not provide any information.

Question 12

What is oncotic pressure?

Accepted Answer

Oncotic pressure is the force exerted by large molecules, such as albumin, in the bloodstream. These molecules attract water, causing it to be pulled into the bloodstream and exerting a pulling or suction force. This is important in maintaining proper fluid balance between the bloodstream and tissues. Option A and B are incorrect as they describe hydrostatic pressure and electrolyte pressure, respectively, which are different from oncotic pressure.

Question 13

A registered nurse is teaching a student nurse about the reason for the development of natriuresis. Which statement made by the student nurse indicates effective teaching?

Accepted Answer

Natriuresis develops as a result of the excretion of large amounts of sodium. The term "natriuresis" refers to the excretion of sodium in the urine by the kidneys. This is often seen in conditions such as heart failure or cirrhosis, where there is an increase in the level of a hormone called atrial natriuretic peptide, which leads to increased excretion of sodium and water. This results in a decrease in blood volume and helps to reduce blood pressure.

Question 14

Which IV fluids should be avoided for a client with cerebral edema?

Accepted Answer

Hypotonic solutions should be avoided in clients with cerebral edema as they cause a shift of fluid from the blood vessels into the brain cells, worsening the edema. Isotonic or hypertonic solutions may be used depending on the specific situation, but should be administered cautiously and with close monitoring.

Question 15

What is the daily potassium requirement of humans for optimal cell functioning?

Accepted Answer

The answer of What is the daily potassium requirement of...

Question 16

A client is on digitalis and the lab results show that the client is hypokalemic. What effect could hypokalemia have on the drug administered?

Accepted Answer

Hypokalemia can increase the risk of digitalis toxicity because low potassium levels can enhance the effect of digitalis on the heart, leading to an increased risk of arrhythmias.

Question 17

A nurse is caring for a client who has undergone cardiac surgery. What is the best method to assess the client's fluid loss or gain?

Accepted Answer

Measuring body weight daily is the most accurate method to assess fluid balance, as 1 kg of weight gain or loss is roughly equivalent to 1 liter of fluid gain or loss. Vital signs provide additional information on the client's hemodynamic status.

Question 18

A client's serum phosphorus level is 5.5 mg/dL. Which clinical manifestations would the client exhibit?

Accepted Answer

The answer of A client's serum phosphorus level is 5.5...

Question 19

A client's lab results show overproduction of aldosterone. What is the best nursing intervention to maintain serum electrolytes levels in the client?

Accepted Answer

Administration of spironolactone is the best nursing intervention to maintain serum electrolyte levels in a client with overproduction of aldosterone. Spironolactone is a potassium-sparing diuretic that works by antagonizing aldosterone, which leads to decreased sodium reabsorption and potassium retention. This helps to maintain serum levels of potassium and sodium in the body. Recommending sodium-rich foods or administering sodium chloride injection may exacerbate electrolyte imbalances in this case. Magnesium sulfate injection is not typically used to address electrolyte imbalances associated with aldosterone overproduction.

Question 20

A physician orders IV potassium infusion for a hypokalemic client. Which intervention should be avoided by the nurse while administering IV potassium?

Accepted Answer

Administration of hypertonic potassium chloride IV bolus should be avoided as it can cause cardiac arrest. Potassium should be administered slowly and diluted to prevent adverse effects. A typical dose of potassium chloride is 20-40 mEq per hour, not per dose.

Quiz 7: Fluid and Electrolyte Imbalances